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General NPI Number Information
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NPI Number | 1124798855
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Entity Type | Individual
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Provider Name | DANIEL NOLTE PA
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Gender | Male
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 65 VILLAGE SQUARE DR STE 201
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-2569
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Country | US
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Telephone | 401-444-7959
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Fax | 401-515-7910
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Provider Business Mailing Address
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Address Line | 15 LA SALLE SQ
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City | PROVIDENCE
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State | RI
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Zip | 02903-1814
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Country | US
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Telephone | 401-444-6779
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Fax | 401-444-6912
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01370
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License Number State | RI
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